Possibly (hopefully) the first picture of our child(ren).

We are at the beginning of the famous “Two Week Wait”. That’s the term the fertility blogosphere uses to describe the period between an embryo transfer and the blood test that confirms pregnancy. Most couples confronting the two week wait face worse odds than we face. Infertile couples that seek out IVF often have underlying factors that don’t apply to an egg donor and gestational carrier with demonstrated fertility and a biological father with sperm that has been tested and is presumed effective. But that doesn’t mean we’re not going to be stressed out for these two weeks.

On Friday, we traveled to the IVF clinic so that we could be present for the transfer. Our attendance wasn’t required – I’d already performed my end of the deal – but we wanted to be there to see B. again in person and for moral support. We didn’t realize we would also be able to watch the procedure.

B. arrived just after we did. She didn’t even have time to tell us about her trip before the nurse entered the waiting room and called her name. As B. got up, the nurse looked past her to us. “Are you Jonathan and his partner?”

We looked around to see who she was talking to.

“This is Philip and Alberto,” B. said.

“Oh, okay,” the nurse said. “Come with me.”

We followed her to a consultation room, but I was thinking, Who the hell is Jonathan? These people better not transfer Jonathan’s embryos into our carrier.

The nurse left us in the consultation room and went to get some paperwork. B. told us about her drive. She came with her boyfriend and their two kids, who were waiting back at the hotel. They were able to spend the previous day in New York City and they had a good time.

When the nurse returned, she held out a clipboard and asked, “So which one of you is Jonathan?”

Honey, there is no Jonathan. Go find the paperwork for Philip and Alberto.

Before we could say anything, she checked the clipboard again. “I’m sorry, Philip, which one is Philip?”

I raised my hand and took the clipboard. She gave paperwork to B. as well. “Are you two going to be present for the transfer?”

We turned to B. The nurse assured her that it would be modest. We would remain above the neck and watch the procedure on the ultrasound. The whole process would take about five minutes. B. said she felt comfortable with us being in the room.

The nurse gave B. some instructions regarding medication and behavior following the transfer. B. was going to need to take it easy for the next 48 hours, not walking very far or lifting more than 15 pounds. She was not to swim or even take a bath (showering would be fine). Then for the next two weeks she shouldn’t exercise, but other than that her life could go back to normal. I want to assume “normal” means strictly healthy behaviors and an excessive concern for safety.

The nurse left the room to get us the sterile garments we would have to wear over our clothes while in the operating room. Very soon after that, the doctor came in with pictures of the two embryos he would transfer. Most people have to wait for an ultrasound to have the first picture of their baby, but we have pictures of our child(ren) when they were only 8 cells big.

The doctor asked B. how she was feeling and she said she was a little nervous. The doctor assured her that the procedure would be completely painless, but I don’t think she was concerned about pain. I think she was thinking about her responsibilities that were about to begin. Until that point, her obligations were to give herself daily injections of hormones, drive to the monitoring clinic once a week and speak to us on Skype. If the transfer worked, she would now be responsible for a human life.

The nurse returned with hairnets, shoe covers and a gauzy apron for Alberto and me to wear and took B. to a separate room to change into her hospital-type gown. We were given approximately 30 seconds to put on those items before another nurse appeared and hustled us out of the consultation room.

The operating room (do you still call it that if there’s no scalpel involved?) looked like a standard office in a depressing office park – drop ceilings, harsh lighting, beige walls, bland art. The exception was the gurney and stirrups in the middle of the room with an old-looking monitor attached to it. A frenetic Paul Simon song was blaring from hidden speakers. Alberto said the song reminded him of the bakery where he worked during college.

A different nurse entered with B. and got her situated on the gurney. She asked B. again how she was feeling. B. said she was fine, but looked more nervous than before. Alberto and I sat behind her and focused our attention elsewhere as they put her legs in stirrups and shined a spotlight beneath the sheet that covered her. I didn’t blame B. for feeling uncomfortable and thought that maybe it would have been better if we had waited somewhere else.

But then the nurse switched on the monitor and put the ultrasound wand up against B.’s belly. As the white lines that signified her womb appeared on the screen I realized that I was about to witness something profound. Not the moment of conception, that had already happened. I'm not even sure what to call it, but certainly it’s a milestone in the life of my child. A different kind of starting point.

The doctor came in and again asked B. how she was doing. He again assured her that the process would be painless, missing the point. He asked for something more calming to be put on the radio and the nurse switched on some dramatic classical music. It was the sort of soundtrack you would expect to hear as the Starship Enterprise soars through space.

The doctor set about doing something beneath the sheet that I ignored, concentrating on the monitor. After two minutes, a door opened in the back of the room and a woman came through holding a catheter. “B., Alberto and Philip,” she announced. The doctor nodded and she handed him the catheter. I was glad nobody mentioned Jonathan.

After handing the catheter containing the embryos to the doctor, the woman disappeared through the door again, her participation in this task apparently complete. I cynically wondered how much we had just paid for the woman to carry the embryos from the lab to the operating room and how one gets that job. Is the main requirement that you can walk without tripping over your own feet? (I’m imagining a Mr. Bean episode where Rowan Atkinson is hired in this capacity and hilarity ensues as he stumbles about accidentally impregnating things.)

We returned our attention to the monitor as the doctor guided the embryos to their resting place. On the ultrasound monitor, the tip of the catheter looked like a bright, white speck of light moving through the darkness. I’m not sure if the catheter had an actual light at its tip – wouldn’t that burn the embryos – or if it was some kind of material designed to show up as a light on the ultra sound. The doctor watched the monitor as he maneuvered the embryos into place in the upper third of the uterus. I don’t know how he picked the place where he finally set them down, perhaps it had good feng shui, but again, the whole process took less than two minutes.

Then he removed the catheter, switched off the spotlight and they wheeled B. out of the room. The doctor shook our hands and wished us good luck. The nurse led us to the recovery room where B. would have to wait for an hour before she could get out of the bed.

We waited with her in the recovery room and finally got to spend some quality time with her. She said that she had lain awake the night before thinking about how this could change all of our lives. I admitted that I wasn’t even thinking about that. I had been up worrying about whether the procedure would be successful.

And that’s still where I am. I think I’ve already done the thinking about how much my life will change when the child is born. For the time being, I’m spending all of my worrying just hoping we get good news in two weeks. It’s going to be a long wait.

If you believe life begins at conception, I am now a father of nine.

Our egg donor flew to Connecticut on Friday night and underwent lab tests over the weekend. Yesterday, she was “retrieved”. That means that the IVF clinic took eleven eggs from her. It seems weird to say that the eggs were “retrieved” – that makes it sound like I was hiding them in her ovaries for a while and now I want them back – but that’s the terminology they use. Of those eleven eggs, two of them “degenerated”. I’ve seen pictures of this online and it’s not pretty. They look like broken chicken eggs, like the doctor dropped them on the way to the petri dish.

The 9 remaining eggs were ICSI’d and resulted in embryos. Now we wait for them to grow. If they divide to 8 cells or more, they are eligible for transfer. B. leaves for Connecticut tomorrow and will undergo additional lab testing on Thursday. If all is well, the transfer could happen on Friday. If the embryos need a little more time to grow, it could be Saturday.

The embryos that aren’t transferred will be frozen. With current technology, a frozen embryo is just as likely to result in a pregnancy as a “fresh” one, so we will have these embryos available as a back-up if the first transfer doesn’t take.

It’s hard not to think about the embryos growing and dividing in Connecticut while I’m sitting here at my desk in Massachusetts. Is this the way the entire pregnancy is going to be?

I’m going to try not to let this blog devolve into a critique on The New Normal, but as we prepare for the events of next week, this week’s episode really hit home. In the episode, Bryan – in a fit of gay enthusiasm – buys a bunch of baby clothes despite his agreement with David not to buy anything for the baby until they are further along in the process. David is nervous about all of the things that can go wrong with the pregnancy and doesn’t want to fully commit emotionally until they are sure they are going to have a healthy baby.

Alberto has only bought two items of clothing for our unborn (actually, un-conceived) child. But we, too, had a pact that we were not going to buy anything until a sonogram detects a heartbeat. Like David, I can’t stop thinking about all of the things that can go wrong. I don’t think it’s because I don’t want to fully commit emotionally to this child (we’re way past that point already) but I think it is just dumb superstition that’s keeping me from telling people and buying baby items. (It might also be the knowledge that, unencumbered by a baby buying embargo, Alberto and I could go buck wild and decimate a Baby Gap.)

I’m not going to be able to stop worrying (I am my mother’s son). But I will try to take the tidy, wrapped-up-in-a-bow advice from the show and learn how to celebrate the wins and enjoy the ride. And the embryo transfer next week is going to be something to celebrate. We can worry about whether it was successful later. And then we can worry about the amniocentesis. And then we can worry about… Well, you get the idea.

There was another thing in the episode that hit home. At the end Nana says, “I assume you gays have wine?” and Bryan responds, “By the cask.” Amen to that.

Last night, I watched the pilot of “The New Normal” – NBC’s new comedy about a gay couple going through the process of gestational surrogacy. I think Ryan Murphy might be stalking me. Surely he got the idea for “Glee” from watching me sing to my cat.

But there are a lot of differences between David and Bryan’s experience and ours. First, and perhaps most importantly, David and Bryan are rich. Bryan drives a Range Rover; I drive a Honda Civic. Bryan shops at Barneys; my Barneys jacket was a “gift” from the lost and found closet at my previous place of employment (it had been there 4 months, don’t judge).

Because of their wealth, David and Bryan make the choice to expand their family through surrogacy very easily. It is a matter of weeks between their decision to become parents and their first meeting with a surrogacy agency. (The agency is called “Expanding Families” which is clearly a play on the name of “Company A”, the organization that asked me about my menstrual cycle on their questionnaire.) Alberto and I have been on this path for five years and there have been a number of setbacks and challenges that David and Bryan, with their “platinum plan”, will not have to face. For instance, when things go wrong with their first surrogate, whom Bryan refers to as a “womb terrorist”, they are able to move quickly on to a different carrier. If our relationship with B. devolves into a hostage situation, we’re screwed.

A second difference is that Bryan decides that he wants to be a parent in, like, five minutes. He sees a cute baby at the mall and decides he wants one too. David is easily convinced, but up until then he was content to raise puppies instead.

As I mentioned before, Alberto and I have wanted to be dads our entire adult lives. And as much as I love my cat, he is never going to be a substitute for a child. I think it is dangerous to portray David and Bryan’s quest to become parents as a pursuit of a status symbol because there are many people out there, even within the gay community, that see the recent increase in the number of gay families that way. I get that this is a comedy, and Bryan is already a collection of gay stereotypes played for humor (which I am not generally opposed to), but I don’t think it would have detracted from the comedy to have the intended parents have a more sympathetic or well-considered motive for wanting to become parents.

In the show's defense, it seems to have moved quickly beyond the topic of initial motivation and David and Bryan now appear to want a child for more noble reasons.

Finally, David and Bryan have chosen a carrier that lives in their community. I think it would be great to have B. closer to us so that we could see the pregnancy progress on a daily basis. (And I do mean daily, which is probably why B. will be glad we live a dozen states away.) Unfortunately we will have to make do with Skype, which I understand would be awkward for the TV show.

And now for one of the things that makes me think Ryan Murphy is living under my porch. David and Bryan decide to use David’s sperm because David is an only child and carrying on his DNA would be important to his family, while Bryan has a big family - brothers with kids and a gay sister.

 Ryan, while you’re under there, watch out for the woodchuck.

Finally, finally our egg donor has signed the contract and we are moving forward again. There were many events that couldn’t happen until she signed and now it seems that they are all happening at once.

The first thing we need to do is to fill out an application for “complications insurance” for both the donor and the carrier. This is separate from the insurance that will cover the pregnancy. If either woman has a bad response to the medications they will have to take before we can attempt an embryo transfer, this is the insurance that will cover them.

I do not have a problem with this insurance; I think it makes sense. Other than the possibility of an adverse reaction to the medication, the doctor is going to be inserting a hollow needle into the donor’s ovaries. I can understand why we’d all want some coverage for that procedure.

However, I do have a problem with the (ridiculously expensive) insurance that we have to buy to cover the pregnancy. B. will be pregnant with my biological child. If she had become pregnant with my child through an improbable, random encounter, my insurance would cover her pregnancy (assuming I survived after Alberto found out). But since this pregnancy is planned and wanted, it is not covered. Although I understand the financial reasons to have such a policy, I think it sends an inappropriate message to society.

Despite the fact that the complications insurance isn’t in place yet, both women have been sent their medications (I hope this blog post will not be used as evidence in a denial-of-coverage hearing). We spoke with B. over the weekend and she will now give herself a daily shot of hormones in the leg. She said it wasn’t so bad, but I’m glad I’m not the one who has to get a shot every day. The shot will make her uterus into a more welcoming environment, like a Starbucks.

Instead of world music and soft lighting, her uterine walls will grow more robust. They will develop an infrastructure of capillaries that the embryo can cling to. Picture a cliff with vines growing on it. Now picture someone being throne off that cliff, clamoring to grab the vines on the way down. This medication grows more vines. I guess that's not really like a Starbucks.

Since the donor is anonymous, we don’t know much about her experience with her medication, but I know that it’s supposed to suppress her menstrual cycle so that there is a traffic jam of eggs in the ovaries. Another drug is supposed to “ripen” the eggs. Finally, just before retrieval, she takes something called the “Trigger Shot,” which is kind of like the starter gun at a track meet. It releases the eggs from their follicles and makes them available to that probing needle.

The final thing we need to do now is to make travel plans because the first attempt at an embryo transfer will be September 28 (give or take a day). Keep us in your prayers.

I haven’t posted in a long time because nothing is happening. So I decided today that I would post about the fact that nothing is happening.

The Egg Donor has had our contract for almost a month now. According to our surrogacy agency’s policy, she was supposed to have her requested changes back within five days. The agency has been in contact with her and assures us that she is working on the contract. They say that she has started her medications, which she is not obligated to do until the contract is signed. They say that she is just being “meticulous”.

Honey, I get meticulous. You are about to create a life. You will most likely never meet this child and you are entrusting him or her to a couple of people about whom you only have a few pages of information. But you knew the deal when you added your name to the registry of potential donors. It became more real for you when you were chosen and you got to see pictures of the two people who will raise the baby you will help to make. It got damn real when a doctor gave you a pelvic exam during your medical screening. You have had many chances to pull out along the way, but you have continued the process.

Sign the contact.

Under our original timeline – the timeline that included five days for donor contact review – B., our carrier, would have delivered the baby around the first of May, assuming the first embryo transfer was successful. This would have allowed Alberto to take his two weeks of paternity leave and then a small, unpaid leave of absence before his summer vacation started. If the first transfer was unsuccessful but the second transfer worked, the baby would be born about two weeks into Alberto’s vacation. In either of these scenarios, we would have had a few months with the baby before we would need daycare. Every week that you wait to sign the contract reduces the amount of time we will have with the baby before he or she needs daycare and makes it more important that the first transfer is successful.

Sign the contract.

In addition to the timing issues this delay creates, there is also the psychological effect of waiting. We don’t know if you are having second thoughts. We don’t have a back-up egg. None of the other donors we looked at were as good a fit. If we need to go with a different donor, that only adds more weeks to the journey. We keep having our weekly Skype conversations with B. and she’s waiting to move on to the next step of this process, too.

Please, sign the contract.

The fertility clinic called today to give me the results of the analysis of the Specimen. I already knew from my previous semen analysis that My Sperm are ready for action, but will need oddly-shaped headwear if attending a royal gala. But now I also know some details about this particular effusion, which is the one that counts.

First, my sperm count is 8x the normal level to be considered fertile. Apparently, under different circumstances, I could have been prolific as an Irish Mormon. (Is there a macho bravado thing that should accompany this revelation? Because I don’t really feel it. I’m more bothered about all that useless fecundity.)

Second, there are more golden retrievers than potheads. They are ready to be combed.

Third, they are at least average in speed, rating a 2.5 on a scale of 0-4. Not exactly Michael Phelps, but they will do. I’m not sure how relevant this is anyway, since we are using ICSI; you don’t have to be fast if you’re being shot out of a cannon.

Now, assuming encasing them in carbonite (or, whatever) doesn’t damage them, there will be no need for a second retrieval. Under the circumstances of that first experience, I’m happy to hear that.

The other medical procedures of Marathon day were more mundane than the production of The Specimen. After our consultation with the nurse and the IVF doctor, the nurse took B. to an examination room and another nurse led me off to the cheerful lab technician. Alberto was left in the conference room by himself.

After the specimen, I returned to the conference room for a brief moment, where Alberto declined to hear the story I posted yesterday.

Next, I filled out a questionnaire about my hematological history. If you’ve ever donated blood, you’ve filled out this same questionnaire – have you traveled to Africa (yes), do you have a tattoo (yes), have you had sex with another man since 1977 (duh), used intravenous drugs (no), had sex for money (no), had sex with someone from Africa (no, but this seems like an oddly racist risk factor).

I took the questionnaire to the phlebotomist and sat down in her chair. I noticed she was reading a Twilight book. “You’re a phlebotomist and you’re reading a book about vampires? Does that make people nervous?”

“Does it make you nervous?”

Um, it didn’t until you gave a creepy response to my playful question. She managed to draw six vials of my blood without its scent whipping her into a frenzy, though, so I’ll assume she doesn’t sparkle in the sun.

Again, I returned to Alberto’s room of isolation. The first nurse that we met with in the morning returned with a stack of paperwork. Apparently the regulations governing IVF are similar to the regulations that govern the purchase of real estate, because the only other time that I have signed that many documents was when we bought our house. The nurse gave a brief explanation of each form, because if we had read every word we would have been there all week.

After we had both signed all of the paperwork, my final nurse of the day took my blood pressure, listened to my heart and lungs and pronounced me healthy. Meanwhile, B. was having similar tests and procedures, as well as having a sonogram of her uterus and receiving instructions on how to take the drugs that she will need to take to prepare her body for surrogacy.

Finally we were all returned to the conference room where Alberto had been reading his book for three hours. The nurse told us that B. had a lovely uterus and it was her turn to blush. These are the sorts of intimate details that you don’t normally discuss with people you barely know, but I’m getting more used to it.

At the end of Marathon Day, as we were driving back home, we were excited about the next steps. We knew that the Egg Donor would have her medical testing the next day. If that was also successful, all the pieces would be in place to schedule the transfer.

The Specimen. It sounds like bad science fiction – like something reptilian, lurking. But yesterday morning a disconcertingly jovial man in a sterile hair net handed me a cup and told me to produce one. When I “produced” my specimen for the semen analysis I was able to take the cup home with me. I was able to “produce” in silence and obscurity. I was able to produce on my own timeline. Then I transported that specimen to the lab in my pocket (it’s supposed to remain as close to body temperature as possible).

But yesterday I had to have conversations about my specimen. I had a particular time and location to produce it. Theoretically I had all morning, but there were people waiting for me. People who saw me enter the bathroom and had a job to do post-production.

One of the questions I asked in the consultation room with the nurse earlier that day was if this specimen was going to be The Specimen. “Yes,” she said, “so make it a good one.”

I appreciated the tension-diffusing humor, but blushed anyway.

She led me down the hall and passed me off to the jovial lab technician. He had a few forms for me to fill out and told me there would be more to complete when I got back. What great foreplay and afterglow – forms.

He handed me a cup and had me write my name on it. We walked down another hallway lined with offices. All of them were filled with people who turned to watch me pass with my cup. The technician was in a great mood, laughing and making jokes. I was deadly serious.

He pointed to a room, “This one is my favorite.”

I tried to put that image out of my mind entirely. I pulled the door closed and got ready to produce. Unfortunately, there were a number of distractions.

Distraction 1: The woman outside the door talking about her son’s stomach flu. She and her co-worker – who must have had offices right next to the specimen room, lucky them – discussed her son’s symptoms in detail. Projectile vomiting, diarrhea, cold sweats. The works. I’m sorry for her son, but for God’s sake, I’m trying to make a baby here.

Distraction 2: The porn. In the rack on the wall, in full view, was a magazine with a naked woman on the cover, holding a gasoline nozzle in front of her crotch. I did not open the magazine, but I hope that in its pages the use of the nozzle never ventured beyond the realm of the symbolic. I do not pretend to understand this image or its erotic appeal, but it remained within my peripheral vision. Eventually, I turned the magazine over revealing all manner of other perversions.

In desperation I reached for the Purple Folder, labeled “Alternative”. It was offensively thin in comparison to the legion of materials on hand for the production of heterosexual specimens. It too contained all sorts of odd scenarios: naked man on the deck of a ship, naked man by a lamppost, naked man with a shotgun (presumably for the Log Cabin Republicans in the audience). I closed the folder, but used it to cover up the other magazines, so now I was only looking at a purple rectangle. (And can we talk about the fact that the gay porn was concealed, while the straight porn was out in the open? Can they get a filing cabinet or something?)

Distraction 3: Bette Midler, on the radio, singing “God is Watching Us”. Here I am, holding a folder full of gay porn, the image of the lewd service station attendant burned into my retinas, trying to produce, and Bette Midler is signing a song about how we are never out of sight of the Divine.

Eventually, miraculously, triumphantly, I was able to produce the Specimen. I took it back to the lab technician and handed it over.

“How’d it go?” he asked.